Prior Authorization Technician
Spectraforce
US
Remote
2 hours ago
Job Description
Position Title: Prior Authorization Technician
Work Location: Remote
Assignment Duration: 12 Months
Work Arrangement: Remote
Position Summary:
• Answer inbound calls regarding authorizations within established time frame
• Document contact information in electronic care management system
Key Responsibilities:
• Answer inbound calls regarding authorizations within established time frame
• Document contact information in electronic care management system
• Ensure all necessary information is entered in electronic care management system
• Review and approve requests based on Medicaid Business Segment established guidelines
• Ensure requests are forwarded to correct location according to established review process
• Contact referring provider to obtain additional information needed to make determination
• Fax decisions to requesting providers
• Provide education to providers and facilities regarding proper authorization procedures and inform them of any updates as needed
• Initiate interdepartmental coordination to ensure quality and timely care for members.
• Additional duties as assigned
Qualification & Experience:
• 1 year of experience in effectively using interpersonal communication skills, especially via telephone
• 1 year of experience using electronic Care Management systems
• High School Diploma or GED in general field of study
• 1-2 years Prior Call Center experience preferred
• 1-2 years Medicaid/Medicare experience preferred
• 1-2 years Prior Managed Care experience preferred
• Completion of Medical Assistant program
• Knowledge of medical terminology
• Computer experience necessary
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $ 22.00/hr.
Work Location: Remote
Assignment Duration: 12 Months
Work Arrangement: Remote
Position Summary:
• Answer inbound calls regarding authorizations within established time frame
• Document contact information in electronic care management system
Key Responsibilities:
• Answer inbound calls regarding authorizations within established time frame
• Document contact information in electronic care management system
• Ensure all necessary information is entered in electronic care management system
• Review and approve requests based on Medicaid Business Segment established guidelines
• Ensure requests are forwarded to correct location according to established review process
• Contact referring provider to obtain additional information needed to make determination
• Fax decisions to requesting providers
• Provide education to providers and facilities regarding proper authorization procedures and inform them of any updates as needed
• Initiate interdepartmental coordination to ensure quality and timely care for members.
• Additional duties as assigned
Qualification & Experience:
• 1 year of experience in effectively using interpersonal communication skills, especially via telephone
• 1 year of experience using electronic Care Management systems
• High School Diploma or GED in general field of study
• 1-2 years Prior Call Center experience preferred
• 1-2 years Medicaid/Medicare experience preferred
• 1-2 years Prior Managed Care experience preferred
• Completion of Medical Assistant program
• Knowledge of medical terminology
• Computer experience necessary
Applicant Notices & Disclaimers
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At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $ 22.00/hr.